Overview

In some men and young adolescents, one or both breasts enlarge, resulting in an unusually large breast. This condition is called gynecomastia.

The enlargement of breast in men occur at adolescence in fifty to seventy percent of all gynecomastia cases. The underlying reason is mostly natural changes in estrogen and testosterone. A short-lasting gynecomastia can be observed in infants. This condition occurs when maternal estrogen hormone persists in blood for a while.A similar condition is faced in middle-aged and older men. Aging (resulting in changes in hormone levels) or below listed medications cause enlargement of breast(s) in men.

Causes

Gynecomastia is usually caused by natural changes in hormonal balance of the body. Therefore, gynecomastia is most commonly diagnosed in adolescents. Abnormally high estrogen – the hormone that regulates female sex characteristics – and abnormally low testosterone – the hormone that regulates male sex characteristics – leads to abnormal enlargement of breast in men.In addition, below listed medications and substances may cause gynecomastia:

• Antibiotics
• Heart medicines
• Anti-anxietic agents
• AIDS medications
• Tricyclic antidepressants
• Chemotherapy
• Drugs used in treatment of peptic ulceration
• Marihuana and heroin
• Amphetamines and steroid agents

Finally, medical conditions that influence blood level of testosterone, aging, heavy alcohol consumption and liver, kidney and thyroid diseases are among factors that lead to gynecomastia.

Diagnosis

The definite cause of gynecomastia may not be always determined.

Determination of the underlying cause and final diagnosis requires a detailed examination by an endocrinologist and/or general surgeon.

The detailed physical examination is usually followed by analysis of hormone levels in blood and imaging studies (mammography, computed tomography, magnetic resonance imaging) to visualize the abnormal enlargement of breast(s).After all those tests and studies are completed, the underlying cause is determined and the final diagnosis of gynecomastia is made, but it is possible to determine no etiological factor.

Treatment

Gynecomastia usually does not cause a symptom, excluding enlargement of breast and varying degree of tenderness. In some advanced stage cases, pain and discharge from nipple of one or both breast can be seen.

As the condition may spontaneously regress over time without need to a treatment, your endocrinologist or general surgeon may first consider treatment of underlying cause or follow-up for a particular period, if no etiological factor can be found.

Inability to determine a causative factor, absence of spontaneous regression, occurrence or aggravation of pain, discharge and tenderness and social reasons may point to surgical treatment of gynecomastia.

Gynecomastia arising out of breast cancer is extremely rare in men. However, if your doctor has concerns about a tumor, it is necessary to verify or rule out cancer by mammography and biopsy.If you want surgical treatment of gynecomastia, please consult our plastic surgeons for techniques, expectations, and potential risks.

You should discuss aim with our plastic surgeons and endocrinologists in order to get most realistic and satisfactory outcomes before deciding surgical treatment of gynecomastia.

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